LARA COOLEY PORTMANN

SALT LAKE CITY, UT
NPI1972669182
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: UT  4942578-4405)
Enumeration Date2006-12-29
Last Update Date2008-03-18
Business Address
-- LARA COOLEY PORTMANN APRN
8TH AVE C ST
SALT LAKE CITY, UT 84143-0001
Phone number: 801-408-1100
Mailing Address
-- LARA COOLEY PORTMANN APRN
PO BOX 27128
SALT LAKE CITY, UT 84127-0128
Phone number: 801-408-1100
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